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A Guide To Crown Hair Transplants

If your hair is thinning or balding at the top of your head, you’re not alone. Balding at the ‘hair crown’ or top of your head is a common experience that a lot of people go through at some point in their lives, especially those with a family history of hair loss

There are many treatments available, from non-surgical hair loss treatments, to crown hair transplant procedures in the form of an FUE hair transplant that can retrospectively help with the regrowth of hair in the crown. 

In this guide, we’ll be talking about everything from what the crown is through to causes of hair loss in this area and treatments available.

What is the hair crown?

The crown or ‘vertex’ of your hair is located on the highest point on top of your head. The hair that grows from this point, congregated around your scalp in a circular pattern or formation, is called a “hair whorl”. You may even have two hair whorls in your crown which is also known as a ‘double crown’. This is also normal.

What is a crown hair transplant?

A crown hair transplant is an FUE hair transplant procedure that involves the surgical removal of individual hair follicles from donor areas found on the back and sides of the head that are extracted and transferred to the affected crown area.

How to tell if your hair is thinning at the crown

As part of the process of male pattern baldness, you may notice your hair starting to become thin at your crown. This is because dihydrotestosterone (DHT) targets not only the hairs on the front and top of your head but also your crown.

This is depicted in the Norwood scale for male pattern baldness below:

Norwood Scale, Male Hair Loss

Norwood scale of balding showing the different stages of hair loss

You will notice that the crown can be affected by male pattern baldness. In some men, the crown can thin and bald quicker than the front of the head. In others, it can thin and become bald over time in keeping with the natural progression of male pattern baldness. For example, you may realise you have reached Norwood 3 Vertex in your mid-30s or 40s.

Some cases of male pattern baldness can be rapid, with crown and frontal hair thinning & loss by the age of 25-30. This is of course unfortunate for those who value having hair on their head!

Is crown hair loss different?

Losing hair on your crown can appear different from balding on the front. The underlying process that drives crown and frontal hair balding is the same. However, there are subtle differences that mean they look very different.

Because you look at your/someone else’s crown from a steep angle, you look down onto the hair vertically. This means you can see more scalp, especially if you have dark hair and light skin. Have a look at the example below:

FUE hair transplant crown before and after

Hair loss in crown and mid scalp treated with an FUE hair transplant

You can see that there were some hairs in this gentleman’s crown but as they have thinned, more scalp is now visible. This has consequences for crown hair loss treatment.

Treating and preventing crown hair loss

Crown hair transplants are not always the first port of call to realising hair regrowth. We understand that they can be expensive and If you’re just starting to lose your hair, other non-surgical hair loss treatments may be more beneficial. However, it is comforting to know that a transplant can be an option if you find that certain treatments aren’t working. 

By using non-surgical hair loss treatments like Finasteride, Minoxidil, and in some cases PRP injections, you can increase the density of each hair and therefore hide any visible scalp. This means that by treating hair loss, it is possible to hide signs of crown hair loss and balding.

Have a look at the case below. You will notice the patient is experiencing thinning and balding of his crown. By taking treatment to promote hair growth and thicken hair he has treated his hair loss and hidden more scalp in his crown. This has reversed his Norwood 3 Vertex/ Norwood 4V, to a Norwood 2V/ Norwood 3.

Hair re-growth crown

Hair regrowth following 5 months of medical hair loss treatment

What about a crown hair transplant?

Unlike hair transplants at the front of the head, crown hair transplants generally require a lot more hair. This is because of the angle with which you look at the crown. 

Take the picture above as an example. We are looking directly down onto the gentleman’s crown. Each hair is pointed directly at us and therefore less of the hair shaft is covering the surface of the scalp from our viewpoint. This means more scalp is visible.

For this reason, when we perform hair transplants on the crown, we require a larger volume of hair. This allows us to cover more area in the crown and make the signs of hair loss less obvious.

Because crown hair transplants require a greater volume of hair, your surgeon needs to carefully plan your operation. With a higher number of grafts needed, you and your surgeon will need to take into account the following points:

  • How much hair do you have on the back and the sides of your head?
  • Are your hairs thick or thin?
  • The approximate number of grafts required to give you the desired coverage
  • If you need a high number of grafts (e.g. >2000 follicles) then how will your surgeon plan the operation to make sure they all survive?
  • If it is a lengthy procedure should you and your surgeon consider splitting the operation over 2 sessions?
FUE hair transplant crown before and after

6 months of early growth following a crown hair transplant

Crown hair transplants can also be tricky to take care of once you have finished your operation. Because new grafts have been put into your crown, sleeping at night can be problematic. You might need to sleep at an angle to make sure you protect your grafts in the first 14 days.

As the grafts are at the back of your head, you might find that you forget they are there! We have had a few patients bump their heads getting in and out of cars in the first few days after the operation. This is particularly problematic on the day of the operation. As you have had your head numbed, your ability to know where the top of your head is in relation to ceilings, roofs, and doors can be impaired, so we make an effort to escort you to a car or taxi.

Going through this hair transplant aftercare journey with your hair transplant surgeon is important. They need to make you aware of all the nuisances that you might encounter in the days following your operation.

Choosing to have a hair transplant

As we have mentioned before, choosing to undergo a hair transplant should be a well-thought-out decision, (read our blog on ‘5 things to consider before a hair transplant’).

We encourage you to make sure your hair transplant surgeon is fully registered and licensed, including the clinic they work at. In the UK this includes both:

  • A GMC registration for the Surgeon
  • A CQC license for the clinic (take a look at our CQC license)

At The Treatment Rooms London, we welcome new patients exploring treatment options for their hair loss before deciding upon a hair transplant. As discussed above, this doesn’t have to be your first port of call. 

For more information as to how The Treatment Rooms London will be able to help you with any non-surgical hair loss treatments or, to find out more about our FUE hair transplant process, get in touch. Our leading surgeons will book in a consultation whereby all treatment options will be explored culminating in a tailored patient journey specific to your needs.

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